CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Fishermen's Community Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $183
  • Cash Discount Price: $211
  • vs. Medicare Baseline: 9.48x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Fishermen's Community Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 9.48x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$211

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$19.31

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $19.31 (100%)
Cash / Self-Pay: $211 (1093%)
Insurance Median: $183 (948%)
Cash: $211 (1093% of Medicare)
Ins. Median: $183 (948% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $19.31 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 948% of the Medicare baseline (a markup of 848%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $6 - $248 31%
UnitedHealthcare $6 - $324 31%
Amerigroup $6 31%
Wellcare $6 31%
Sunshine State $6 31%
Vista $6 31%
Medicaid / KanCare $6 31%
Blue Cross Blue Shield $54 - $324 280%
Leon Medical $68 352%
Medicare (plans) $68 - $92 352%
Medica Health Plan $68 352%
Humana $74 383%
Avmed $75 - $268 388%
Cigna $78 - $259 404%
Non Contracted $119 616%
International $211 1093%
Dimension Health Plan $243 - $292 1258%
Amerihealth $243 1258%
Affordable $292 1512%
Quality Health $292 1512%
PHCS $292 1512%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals